Teamwork

Teamwork is an important aspect of healthcare. Being a team player is imperative. No one person knows it all, and no one person can do it all. It takes an army, especially in the ICU. Nurses Announcements Archive Article

Teamwork

"5 beats of pulse-less vtach converted to sinus tach" I told the doctor.

"Guys we need the crash cart here fast" I yelled out the hall to my pod mates.

The physician intuitively placed his right hand beneath his left elbow making a 90 degree angle, placing his left hand on his chin.

"Doctor the Bicarbonate is 9, do you think we should do two amps of bicarbonate? I've actively titrated the levophed for the past hour, and I believe it is starting to fail in the presence of this acidosis" I suggested.

---No response---

"Doc....!?" with a higher sense of urgency I questioned.

Breaking him from his pensive state he uttered through his thick accent, "ah yes yes, let us do two amps of bicarb"

It was then when I turned my back to find an army of ICU nurses, ECMO nurses, a crash cart, a group respiratory therapists, junior doctors, and even my nurse manager all behind me. In the most figurative and most literal way possible.

"Two amps of bicarb my dear" my charge said as she handed me the medication. She winked with a smile of assurance.

It was a rather rainy and gloomy day. Large windows in the patients room reveled the dreary and wet, yet shiny, modern, majestic architecture of the adjacent buildings that are also part of the same hospital.

"Two amps of bicarb in at 1722"

The monitor began to display a MAP of 57, 42, and 34 all too rapidly falling, the ECMO machine began to alarm as well.

Quickly without much hesitation, or regret I opened the roller clamp on my blood tubing as to free flow it in. I squeezed the emergent squeeze chamber.

My interventions displaying an effect before my eyes. The MAP rising to a steady 65 after about what seemed to be an hour but was in reality about 2 minutes.

Tapping me on my shoulder was my former preceptor "Here's 1 gram of calcium chloride, next time the pressure drops suggest to the doc to push this"

"Hey I'm writing all this down for you dude" another nurse called out from the corner.

Through the course of the next hour a series of events occurred. Lethal cardiac arrhythmias, lab results close to being incompatible with life, the addition of 5 vasoactive drips, and medication push after medication push. Painful discussions with family. Sobbing and crying from family. The whole sequelae of events we all know too well.

But through this entire experience I had the guidance of centuries of combined ICU experience. Yes as the primary RN I was at the forefront by the patients side with the cardiology fellow, but it was all a team effort.

I want to emphasize to ALL new nurses, but especially NEW ICU nurses that you are never ever ALONE. You have centuries of combined ICU experience at your disposal. Use it. Embrace it. Absorb it.

This is what I love about the ICU. The collegiality, the teamwork, the fresh ideas of the baby doctors, the wisdom of the older more experienced doctors and nurses.

I truly believe that the most dangerous nurse is a nurse that believes he or she knows it all.

When in doubt, ask! When you need help, speak up, ask for help. Don't be ashamed. This is the ICU, sometimes it takes a whole army.

Coming from the floor, I had to learn to be OK with asking for help. As floor nurses, we usually keep to ourselves and since we seldom have emergencies there's oddly a need to have more than 3 people in the room at once.

This kind of teamwork further convinces me more that I want to become a CRNA. I will absorb all this knowledge. All these lessons about teamwork and apply them to the OR one day.

When I'm asked, "Why do you want to become a CRNA?" I will say, one of the reasons is because I want to be part of a team.

CardiacDork is a Registered Nurse with 5 years of experience in general surgery, surgical/trauma ICU, and medical ICU.

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quazar

603 Posts

Love, love, LOVE this about my coworkers on L&D. You know if your baby crashes, you just have to wait about 5-10 seconds and people will magically appear in your room and start bolusing the IV or administering oxygen or doing whatever you haven't already done, and asking you what you need. The doctor will have been called, and if it's really bad, the OR will have been opened and people will start prepping your patient.

A good team is what makes it all so worth it.

sevensonnets

975 Posts

I love this too CardiacDork! THAT's how we work together! And you hit right on it: the nurses who think they know it all are indeed the dangerous ones. They usually get humbled really quick!

It takes a village ... in any unit. Always unfortunate when the village idiot is the doctor.